OMM - Intro to Indirect Techniques

Question 1

Strain/Counterstrain

Answer 1

Ideal for Acute, Painful or Frail patients where HVLA is not indicated or tolerated by patient

Question 1

Tenderpoints are found with Acute and Chronic Somatic Dysfunctions, Somatic –Somatic and Viscero Somatic in origin.

Answer 1

Strain/Counterstrain Indications

Question 2

Tender point

Answer 2

Small zone of tense, tender edematous muscle and fascial tissue about 1 cm in diameter. Sensory manifestation of a neuromuscular or musculoskeletal dysfunction. Does not respond to spray and stretch or injection.

Question 2

General SCS Rules

Answer 2

Treat most tender first. Warn of post treatment flare. Hold position of ease 90 seconds or more. Return to neutral slowly. Anterior Points are usually treated in flexion. Posterior Points are usually treated in extension. Midline Tenderpoints are treated with more extension of flexion. Tenderpoints lateral to midline are treated more with rotation and sidebending.

Question 4

somatic reflex, Strain-Counterstrain corrects the aberrant proprioceptor input thereby decreasing the gamma bias and interrupting the reflex.

Answer 4

In a state of dysfunction, the proprioceptor input to the muscle spindle is altered and the gamma bias is too high.

Question 5

Relaxing the strain patterns in the Peripheral Sensory System, which reduces the proprioceptor and nociceptor signal,assisting the removal of the chemical mediators present, and muscle guarding reflexes. There is a resultant improvement in the local vascular and interstitial circulation that helps healing.

Answer 5

Indirect MFR works by…

Question 6

Strain-Counterstrain Technique

Answer 6

1. Locate tender point 2. Find position of comfort or mobile point 3. Monitor tender point as hold position of comfort for 90 seconds 4. Return to neutral slowly 5. Recheck tender point

Question 7

Counterstrain

Answer 7

AcuteIdeal for Acute, Painful or Frail patients where HVLA is not indicated or tolerated by patient –Hospital, Sports, and Emergency Medicine.

Question 8

The Barrier Concept

Answer 8

Position away from the restrictive barrier into the position of free motion. New neutral point or center of range of motion is created.

Question 9

Strain Counterstrain OMT

Answer 9

A system of diagnosis and treatment that considers the dysfunction to be a continuing, inappropriate strain reflex, which is inhibited by applying a position of mild strain in the direction exactly opposite to that of the false strain reflex; this is accomplished by use of the specific point of tenderness related to this dysfunction followed by specific directed positioning to achieve the desired therapeutic response.

Question 10

Dampens down the mechanoreceptors in the system by reflex inhibition and mechanical relaxation of strain patterns in the proprioceptive system. Very gentle, with no activation of the nociceptive pathways. Valuable for spasm, pain and inflammation.

Answer 10

Indirect Myofascial Release theory

Question 11

Strain-Counterstrain Definition

Answer 11

A passive positional procedure that places the body in a position of greatest comfort, thereby relieving pain by reduction and arrest of inappropriate proprioceptor activity that maintains somatic dysfunction.

Question 13

Superficial, Deep, Subserous, …..One specialized: Dura

Answer 13

Types of Fascia

Question 15

Myofascia Release Technique - Point Of Entry into MS system. Traction and Twist Into and Away from Barrier. Hold and wait 20 seconds. Release slowly.

Answer 15

POE(T)2

Question 15

Trigger point.

Answer 15

Characteristic Pain Pattern referral. Located in muscle tissue. Locally tender. Elicits ‘Jump Sign” on press. Radiates pain from site when pressed. Dermatographia over point

Question 16

Agonist-Antagonist Muscles

Answer 16

The originally strained muscle and the reflexly shortened muscle registerign a false and continuing message of strain (visceral somatic reflex source).

Question 17

Initial phase, depending on health of patient, is a rapid “turning off” nociceptive and proprioceptive protective reflexes. (10-20 seconds average). Second phase is the electrochemical changes of the muscle fiber and resetting of the resting length of the fibers. Third Phase is the “Inflammatory Chemical Wash out”

Answer 17

What happens when in position of Counterstrain?

Question 18

Indirect Balancing

Answer 18

Functional Technique in which the restrictive barrier is disengaged and the dysfunctional body part is gently moved away until tissue tensions are equal in all planes and directions

Question 19

Strain

Answer 19

Injury to a joint occurs. Attempts to return to normal position are inhibited by muscular tension (splinting). Muscle splinting prevents further movement toward the barrier, but does not preclude movement in the direction of free motion. Both agonists and antagonists are affected.

Question 20

Tender Point

Answer 20

Presents with localized pain with vague pattern. Located in muscle, tendon, ligaments and fascia. Locally tender. No radiation of pain when pressed. Jump sign on press. No Dermatographia over point

Question 21

Indirect Balancing (Functional Technique)

Answer 21

Focuses more on the joint motion and requires the constant monitoring of resting motor tone, than movement of tissues and segments. Most useful for paired structures or extremities. Allows gentle treatment of painful and swollen areas. Is often attributed to Harold Hover, D.O. of the early 1900s

Question 22

IMFR disadvantages

Answer 22

Takes time and skill. May not work on subluxatino sites or chronic sites with fibrosis.

Question 23

Piezoelectric phenomenon

Answer 23

mechanical stress transformed into electrical potentials